After analyzing the electrocardiographic findings during anesthesia, we estimated the difference in the incidence of the operative arrhythmia according to preoperative electrocardiographic findings and compared the influence on the occurrence of the operative arrhythmia according to the type of anesthesia(general and spinal) and major inhalational anesthetics. The results were as follows: 1) On the preanesthetic electrocardiographic findings, the number of patients with only normal rhythm was 15 cases. 2) During anesthesia arrhythmias appeared in 15 patients(305) and the most frquent arrhythymis was premsture ventricular contraction. 3) Between the patients with normal presnesthetic electrocardiographic findings and abnormal electrocardiographic finedings, the incidences of operative arrythmias were not significantly different. 4) Thirty percent of patients developed the arrhythmia both in general and spinal anesthesia. 5) The incidence of arrhythmia in halothane and enflurane aneshtesia was respectively 32% and 28% but the difference was not significant.
Anesthesia* ; Anesthesia, Spinal ; Anesthetics ; Arrhythmias, Cardiac* ; Electrocardiography* ; Enflurane ; Halothane ; Humans ; Incidence

PURPOSE: The purpose of this study is to assess the usefulness of dynamic MR imaging after contrast enhancement with Gd-DTPA in the differential diagnosis of hepatic focal lesions. MATERIALS AND METHODS: The population consists of 22 cases of hepatocellular carcinoma, 44 cases of hemangioma, and five cases of metastasis. Diagnosis of hepatocellular carcinoma was made by surgery, fine needle biopsy, ultrasonography, CT and conventional angiography. Hemangioma was diagnosed on the basis of ultrasonography, CT, conventional spin-echo MRI and clinical data. Diagnosis of metastasis was done by fine needle aspiration biopsy. Dynamic and delayed images were obtained using 1.5T superconductive magnetom after Gd-DTPA(0.1mmol/kg) intravenous injection. Quantitative and qualitative evaluation was done for each lesion. RESULTS: Early contrast enhancement with rapid or gradual washout was noted in 15 lesions of hepatocellular carcinoma(68.2%) ;on the delayed images, no contrast enhancement was noted in 18 lesions(81. 8%). Peripheral contrast enhancement pattern was predominantly(86.4%) observed in hemangiomas during dynamic phase. On the delayed images, homogeneous and persistent contrast enhancement of masses were noted in all hemangiomas. Characteristic centripetal fill-in pattern was observed in 32 lesions of hemangioma (72.7%). Contrast inversion of masses during contrast enhancement study was noted in all hemangiomas, while continuous negative contrast was noted in hepatocellular carcinomas and metastases. CONCLUSION: Dynamic MR imaging after contrast enhancement with Gd-DTPA is an useful method in the differential diagnosis of hepatic focal lesions.
Angiography ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential* ; Evaluation Studies as Topic ; Gadolinium DTPA ; Hemangioma* ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Ultrasonography

Infections that occur within the surgical intensive care unit represent a significant cause of patient morbidity and mortality. In addition, hospital-related infections prolong hospital stay and increase hospital-charges. Moreover for the patient with tracheostomy, the possibility of cross-infection may impose an added risk when the general condition is poor. This study was undertaken to investigate the incidence of upper respiratory infection in patients with tracheostomies who had respiratory care in the surgical intensive care unit. The total number of cases in this study was 20, and the specimens for bacteriologic culture were taken especially from the regions of the upper respiratory tract via tracheostomy tubes on the 1,3,5,7 and 10th day after tracheostomy. The results obtained from the bacteriologic culture were as follows: 1_ The most frequently found organism was Pscudomonas aeruginosa, and newxt was staphylococcus, followed by beta-hemolytic streptococcus and Escherichia coli. Gram negative bacilli were 58.9% of all cultured organisms. 2) The greatest number of organism was seen on the third day and frequency of mixed growth was increased in process of time. 3) The comparative sensitivity test of Pseudomonas seruginosa showed that all strains were resistant to ampicillin, erythromyclin, penicillin and tetracycline and 70% of strains were sensitive to amikacin.
Amikacin ; Ampicillin ; Escherichia coli ; Humans ; Incidence ; Critical Care* ; Length of Stay ; Mortality ; Penicillins ; Pseudomonas ; Respiratory System ; Staphylococcus ; Streptococcus ; Tetracycline ; Tracheostomy*

No abstract available.
Veins*

The encapsulated hepatocellular (HCC) is a pathologic subtype of HCC. It is a well defined tumor that tends to grow slowly, and has a better prognosis than any other gross forms of HCC. Twenty surgically resected HCC were evaluated retropectively to correlate the thickness of pseudocapsules in pathology with those in computed tomography and ultrasound. At a histologic examination, pseudocapsules of seven cases were composed of two layers, an inner compact fibrous zone and outer loose fibrous zone interlaced with compressed liver parenchyma containing small vessels and newly formed bile ducts. Sonographic thickness and pathologic measurements of pseudocapsule relatively well correlated, but the former slightly overestimated the thickness of pathologic pseudocapsule (r=0.825, y=2.56x-1.23, P<0.05). On the other hand, thickness in CT and pathologic measurement did not correlate well. Thirteen cases showed one layer of pseudocapsule in which two cases were composed of thin layer of compact fibrosis and eleven cases composed of loose fibrosis. There were poor correlations in this group between thickness of pseudocapsules in pathology and those in images. Image overtly overestimated the thickness of the pseudocapsules in pathology. In conclusion, radiologic pseudocapsule of HCC may represent the compressed liver parenchyma as well as the fibrous pseudocapsule.
Bile Ducts ; Carcinoma, Hepatocellular* ; Fibrosis ; Hand ; Liver ; Pathology ; Prognosis ; Ultrasonography

The encapsulated hepatocellular (HCC) is a pathologic subtype of HCC. It is a well defined tumor that tends to grow slowly, and has a better prognosis than any other gross forms of HCC. Twenty surgically resected HCC were evaluated retropectively to correlate the thickness of pseudocapsules in pathology with those in computed tomography and ultrasound. At a histologic examination, pseudocapsules of seven cases were composed of two layers, an inner compact fibrous zone and outer loose fibrous zone interlaced with compressed liver parenchyma containing small vessels and newly formed bile ducts. Sonographic thickness and pathologic measurements of pseudocapsule relatively well correlated, but the former slightly overestimated the thickness of pathologic pseudocapsule (r=0.825, y=2.56x-1.23, P<0.05). On the other hand, thickness in CT and pathologic measurement did not correlate well. Thirteen cases showed one layer of pseudocapsule in which two cases were composed of thin layer of compact fibrosis and eleven cases composed of loose fibrosis. There were poor correlations in this group between thickness of pseudocapsules in pathology and those in images. Image overtly overestimated the thickness of the pseudocapsules in pathology. In conclusion, radiologic pseudocapsule of HCC may represent the compressed liver parenchyma as well as the fibrous pseudocapsule.
Bile Ducts ; Carcinoma, Hepatocellular* ; Fibrosis ; Hand ; Liver ; Pathology ; Prognosis ; Ultrasonography

PURPOSE: This study was performed to evaluate any difference in the penetration of the acrylic glue into the pig rete mirabile according to the difference of the concentration of the glue mixture. MATERIALS AND METHODS: Three domestic pigs (12-15kg) were used. After obtaining a normal angiography, two different concentrations of 1:1 and 0.5:1 of Histoacryl Blue mixture with Lipiodol were administrated into pig rete mirabile and then anglographic and pathologic findings were analyzed after taking a postembolization angiography. RESULTS: The degree of the penetration of the glue mixture into the pig rete was different in the anglographic and pathologic findings according to the glue mixture ratio. In case of using 0.5:1 mixture of glue and Lipiodol, glue penetrated into the smaller vessels with size of about 80 micro rn than in case of using 1:1 mixture of glue and Lipiodol. CONCLUSION: Because the polymerization time of glue mixture will be different according to the concentration of glue mixture, a mixture with thin glue concentration seemed to penetrate deeply into the pig rete.
Adhesives ; Angiography ; Enbucrilate* ; Ethiodized Oil ; Polymerization ; Polymers ; Sus scrofa

No abstract available.
Arteriovenous Fistula ; Renal Dialysis